The three hospital boards are scheduled to give final approval tonight to seeking proposals from other regional health care organizations on how they might work together.

The meeting is scheduled to begin at 5 p.m. at the WSU Extension Center, 16650 Highway 536 in Mount Vernon.

One of the reasons Cascade Valley is considering the change is that smaller community hospitals have a tough time making it financially. Partnerships mean they can offer the services of other larger health care organizations, said Clark Jones, the hospital’s chief executive.

“It’s difficult to be a small hospital in a suburban or urban area,” he said.

The type of services offered at Cascade Valley tend to be the day-to-day-services that people need most often, such as the emergency room or baby delivery services, he said.

Yet hospitals generally aren’t paid very much by insurance companies or government programs such as Medicaid or Medicare to provide these services, Jones said.

Payment is better for specialty services such as heart surgery, brain and stroke services, and intensive care units for infants, he said. But these services are only provided in larger, nearby urban and suburban hospitals.

Letters requesting business proposals with the three hospitals will probably be sent to the area’s major not-for-profit health care organizations, Jones said.

These could include Providence Health &Services, the parent organization to the private hospital in Everett and the public one in Edmonds; UW Medicine, which operates Harborview Medical Center in Seattle; EvergreenHealth, which has a hospital in Kirkland and approved a business partnership with the public Valley General Hospital in Monroe in September; and PeaceHealth, which operates nine hospitals in Alaska, Washington and Oregon.

Business agreements with Cascade and the other two hospitals could go so far as to include the sale of one organization to another and dissolving the public hospital district. However, Jones said he didn’t think that would be the Cascade hospital board’s preference.

“The affiliation that the board ultimately would agree to would be the one necessary to give our organization what it needs to survive in the future,” Jones said.

The hospital and its six clinics have an operating budget of about $50 million and 550 full- and part-time employees.

In 2008, the hospital had a profit of $5.1 million dollars. Profits slipped to $1.2 million in 2011.

The final numbers for last year are not in, but Jones said he expects the hospital to nearly break even.